While claim adjusters quietly are going about their business, insurers are using predictive modeling schemes and rules-based technology behind the scenes to search for red flags that warn carriers when a claim could be taking a bad turn toward fraud.
Whether it is a softening market or the change in mindset that has developed in a post-9/11 world, fighting fraud still is a major focus for insurance carriers. To do it effectively, insurance carriers have continued to rely on technology tools, though not as much on software specific to fraud. For instance, Erie Insurance Group was an early entrant into the world of predictive modeling for insurance, and Dave Rioux, vice president and manager of corporate security and investigative services, has seen its use grow quite rapidly over the years, largely because of the success insurers have enjoyed with it.
Carriers are looking for software that is more universal–solutions that will help with claim processing and have some fraud benefits, indicates Michael Lucarini, global claims lead for the consulting practice at Accenture. “Making the case for a significant investment in fraud only is challenging,” he says.
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